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Hardware Exposure After Mandibular Reconstruction: Bone Versus Soft Tissue Free Flap Comparison.

Hasan Abdulbaki1, Angeline A Truong1, Laura Chen1

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This summary is machine-generated.

Hardware exposure after microvascular free tissue transfer (MFTT) for mandibular reconstruction is a concern. This study found flap type did not impact exposure risk, but adjuvant therapy significantly increased it.

Keywords:
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Area of Science:

  • Oral and Maxillofacial Surgery
  • Plastic and Reconstructive Surgery
  • Biomaterials Science

Background:

  • Hardware exposure is a significant complication following microvascular free tissue transfer (MFTT) for mandibular reconstruction.
  • Osteocutaneous MFTTs are preferred, but soft tissue-only MFTTs are used when necessary.
  • Limited data exists comparing hardware exposure risk between these MFTT approaches.

Purpose of the Study:

  • To compare the rate and timing of hardware exposure between osteocutaneous and soft tissue MFTTs for mandibular reconstruction.
  • To identify factors influencing hardware exposure risk in patients undergoing MFTT.

Main Methods:

  • Retrospective review of 178 patients undergoing MFTT for mandibular defects (11/2011-6/2023).
  • Primary exposure: flap type (osteocutaneous vs. soft tissue).
  • Primary outcome: time to hardware exposure; secondary outcome: exposure rate at 1 and 3 years.

Main Results:

  • No significant difference in hardware exposure timing between osteocutaneous and soft tissue MFTTs at 1 or 3 years.
  • Adjuvant radiation and/or chemoradiation significantly increased the hazard of hardware exposure at 1 year (HR 7.72) and 3 years (HR 3.68).
  • Exposure rates increased by approximately 10% from 1 to 3 years postoperatively for both flap types.

Conclusions:

  • Flap type (osteocutaneous vs. soft tissue) is not associated with differences in hardware exposure timing after MFTT for mandibular reconstruction.
  • Adjuvant therapy is a significant risk factor for hardware exposure.
  • Surgeons should consider the increased risk of exposure in patients receiving adjuvant therapy.